MRI Conditional Pacemakers
Abstract
Conventionally, magnetic resonance [MR] imaging is an absolute contraindicationfor those with an implanted pacemaker [1].This represents a significant clinical problem as several studies have shown approximately 75% of patients with pacemakers will have an indication for an MRI scan.  Patients over the age of 65 are twice as likely to require an MRI and 80% of pacemaker patients are over the age of 65. MR imaging is an important source of information for neurological disorders and several soft tissue abnormalities. Hence denying this important diagnostic modality for those with an implanted pacemaker and other cardiac implantable electronic devices [CIED] is a tremendous clinical problem both because of concerns about MRI signals interfering with the function of the pacemaker and the pacemaker in turn interfering with the MR images.There are a number of potential effects of MRI signals on cardiac pacemakers and leads. MRI signals can interfere with the function of the pacemaker and the leads as a result of the static magnetic field, the gradient magnetic field, the modulated radiofrequency field and the combined field effects.A lot of research has gone into the development of pacemakers and other CIEDs, which are compatible with MRimaging.References
1. Levine GN, Gomes AS, Arai AE, et al. American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Radiology and Intervention. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance. Circulation 2007; 116:2878-2891.
2. Nair P, Roguin A.Magnetic resonance imaging in patients with ICDs and pacemakers.Indian Pacing Electrophysiol J. 2005;5:197-209.
3. Cronin EM, Wilkoff BL. Magnetic resonance imaging conditional pacemakers: rationale, development and future directions. Indian Pacing Electrophysiol J. 2012;12:204-12.
4. Forleo GB, Santini L, Della Rocca DG, Romano V, Papavasileiou LP, Magliano G, et al. Safety and efficacy of a new magnetic resonance imaging-compatible pacing system: early results of a prospective comparison with conventional dual-chamber implant outcomes. Heart Rhythm 2010; 7:750–754.
5. Wilkoff BL, Bello D, Taborsky M, Vymazal J, et al. Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment. Heart Rhythm. 2011; 8:65-73.
2. Nair P, Roguin A.Magnetic resonance imaging in patients with ICDs and pacemakers.Indian Pacing Electrophysiol J. 2005;5:197-209.
3. Cronin EM, Wilkoff BL. Magnetic resonance imaging conditional pacemakers: rationale, development and future directions. Indian Pacing Electrophysiol J. 2012;12:204-12.
4. Forleo GB, Santini L, Della Rocca DG, Romano V, Papavasileiou LP, Magliano G, et al. Safety and efficacy of a new magnetic resonance imaging-compatible pacing system: early results of a prospective comparison with conventional dual-chamber implant outcomes. Heart Rhythm 2010; 7:750–754.
5. Wilkoff BL, Bello D, Taborsky M, Vymazal J, et al. Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment. Heart Rhythm. 2011; 8:65-73.
